RESUMEN
At a population level APOE4 carriers (~25% Caucasians) are at higher risk of cardiovascular diseases. The penetrance of genotype is however variable and influenced by dietary fat composition, with the APOE4 allele associated with greater LDL-cholesterol elevation in response to saturated fatty acids (SFA). The etiology of this greater responsiveness is unknown. Here a novel surface plasmon resonance technique (SPR) is developed and used, along with hepatocyte (with the liver being the main organ modulating lipoprotein metabolism and plasma lipid levels) uptake studies to establish the impact of dietary fatty acid composition on, lipoprotein-LDL receptor (LDLR) binding, and hepatocyte uptake, according to APOE genotype status. In men prospectively recruited according to APOE genotype (APOE3/3 common genotype, or APOE3/E4), triglyceride-rich lipoproteins (TRLs) were isolated at fasting and 4-6 h following test meals rich in SFA, unsaturated fat and SFA with fish oil. In APOE4s a greater LDLR binding affinity of postprandial TRL after SFA, and lower LDL binding and hepatocyte internalization, provide mechanisms for the greater LDL-cholesterol raising effect. The SPR technique developed may be used for the future study of the impact of genotype, and physiological and behavioral variables on lipoprotein metabolism. Trial registration number NCT01522482.
Asunto(s)
Apolipoproteína E4/sangre , LDL-Colesterol/sangre , Receptores de LDL/sangre , Resonancia por Plasmón de Superficie , Adulto , Apolipoproteína E4/genética , LDL-Colesterol/genética , Hepatocitos/metabolismo , Humanos , Masculino , Persona de Mediana Edad , Penetrancia , Receptores de LDL/genéticaAsunto(s)
Educación en Salud/organización & administración , Promoción de la Salud/organización & administración , Servicios de Salud del Trabajador/organización & administración , Atención Prenatal/organización & administración , Evaluación Educacional , Costos de Salud para el Patrón , Femenino , Investigación sobre Servicios de Salud , Humanos , Enfermeras Clínicas , Embarazo , Resultado del Embarazo , Evaluación de Programas y Proyectos de Salud , Estudios Retrospectivos , Lugar de TrabajoRESUMEN
Staff development educators face numerous challenges because of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards, continuous quality improvement, and economic constraints. For many, the most difficult challenge is complying with the JCAHO requirement for initial and ongoing competency, which must be validated for all nursing personnel. In this article, the authors describe how the educational nurse specialists of a tertiary care, regional referral medical center facilitated the development, implementation, and evaluation of a competency plan to validate initial and ongoing competency for all personnel within Nursing Services.
